The American journal of medicine
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This study aimed to determine whether clinicians are encountering a phenotype of hypertrophic cardiomyopathy that is evolving from the disease recognized several years ago. ⋯ These novel observations are counter-intuitive to practitioners (expecting hypertrophic cardiomyopathy to be associated with particularly substantial hypertrophy), and potentially impact disease recognition, while also highlighting emergence of symptomatic obstructive patients with mild septal thickness < 15 mm, requiring modification of the traditional myectomy operation. While a primary change in the phenotypic expression of hypertrophic cardiomyopathy cannot be excluded by our data, these observations most likely reflect evolving referral practice patterns including greater diagnostic suspicion for the disease in the community particularly at advanced ages, and/or with less substantial left ventricular hypertrophy.
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Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States, between 2010 and 2016, alcohol-related liver disease was the primary cause of nearly 1 in 3 liver transplants, surpassing hepatitis C. ⋯ These alarming trends in mortality from alcoholic cirrhosis in the United States contribute to the formulation of many hypotheses. These require testing in analytic studies designed a priori to do so. Meanwhile, clinical and public health efforts are necessary to curb the epidemics of heavy alcohol consumption and overweight and obesity in the United States that may be contributing to these alarming trends.